HomeMy WebLinkAboutwh appl. 10.22.2018.1pdf SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Y Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE BOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City. City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recWing your Notice of Commencement.
Signature of Owner/Les a/Contractor as Agent for Owner Signature of Contract /License Holder
I
STATE OF FLORIDA - STATE OF FLORIDA
COUNTY OF _s-r- ' C COUNTYOF
The forgoing instr nt was acknowledged before me The forgoing instrument was acknowledged before me
�
this day of lJm
bR_,'Z ,2610 by this AJk day of C>,>�C3-bZ4 26 by
o' A4\/ ,�-tlkiv
Name of person aking statement Name of person making statement
Personally Known fOR Produced Identification Personally Known J- OR roduced Identification
Type of Identi " tion Type of Identificatio
Produced Produced '
{Si nature of Nota "cam lorida) EnkNemoga (Sign4ture of Notary ' Florida) Erik Nemoga
Commission#6G101442 ? = Commission#GG101442
Commission No. r (S }ice;MY 4,2W1 Commission No. Ji'Lli— 4,2021
Bonded thru Aaron Notary +��.,y,�a` �,,,.��' Bonded thru Aaron Notary
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE _ - ---------- - — -- -- --- ----
COMPLETED
Rev. 8/2/17